Provider Demographics
NPI:1659938926
Name:ALVAREZ MARTINEZ, LESTER IBER
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:IBER
Last Name:ALVAREZ MARTINEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12330 SW 192ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-6540
Mailing Address - Country:US
Mailing Address - Phone:786-488-0309
Mailing Address - Fax:
Practice Address - Street 1:12330 SW 192ND TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-6540
Practice Address - Country:US
Practice Address - Phone:786-488-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician